Memorandums on the Human Immunodeficiency Virus Epidemic

Memorandum for Heads of Departments and Agencies

I have approved a 10-point action plan as part of my response to the Report of the Presidential Commission on the Human Immunodeficiency Virus (HIV) Epidemic.

The plan expresses my concern about fair and compassionate treatment of HIV-infected individuals and directs every Federal agency to adopt a policy based on the Office of Personnel Management's (OPM's) "Guidelines for AIDS Information and Education and for Personnel Management." I also have asked American businesses, unions, and schools to examine and consider adopting education and personnel management policies based on the OPM and the Centers for Disease Control (CDC) guidelines.

Many agencies have already adopted policies based on the OPM guidelines. If your agency has not already done so, you should proceed to do so. The Office of Personnel Management is available to answer questions or provide any needed assistance. The Justice Department and the Department of Health and Human Services offer additional sources of information and assistance.

To further encourage businesses, unions, and schools as well as housing projects, correctional facilities, and others to adopt policies based on OPM and CDC guidelines and provide the education that is vital to effective implementation, I also ask each of you to communicate through your programs the value of this approach.

I am directing Donald Ian Macdonald, Deputy Assistant to the President for Drug Abuse Policy, to monitor progress on our response to the Commission's Report and provide me with status reports in September and December, 1988. Please provide Dr. Macdonald with appropriate information about your progress.

RONALD REAGAN

Memorandum for the Secretary of Health and Human Services

I have approved a 10-point action plan as part of my response to the Report of the Presidential Commission on the Human Immunodeficiency Virus (HIV) Epidemic. This plan addresses many issues that fall within the purview of your Department.

In carrying out your functions, I ask that you address HIV-related activities as follows:

1. Review your FY 1989 spending plans to incorporate relevant recommendations of my HIV Commission.

2. Convene a series of consensus conferences over a 12-month period involving State, local, and private groups to encourage them to adopt the specific public health measures discussed in the Commission Report, such as increased counseling and testing, reporting of HIV infection, partner notification, and health care worker safety. One conference should address restrictive measures and criminal statutes directed to HIV-infected persons who knowingly persist in maintaining behaviors that transmit their infection. Another possible topic is the serious problem of neighborhood resistance to facilities for the care of HIV patients, drug abusers, and group homes for HIV-infected infants and children.

3. Increase the number of community-based educational programs, especially programs directed to those women and members of minority groups who are at highest risk of HIV infection. These programs, and especially those directed to youth, should place greater emphasis on my Principles for AIDS Education, especially those encouraging individuals to take responsibility for their efforts to prevent the spread of HIV infection. Please collaborate with the Department of Education in developing youth-oriented programs.

4. Implement actions within the next 45 days that address the blood safety issues raised by the Commission. This plan should address: (a) the prompt notification of transfusion recipients who are at increased risk of HIV infection; (b) steps to improve HIV laboratory quality and HIV screening tests; and, (c) ways to encourage the use of autologous transfusions in appropriate circumstances.

5. Implement actions within the next 60 days to improve and accelerate further the process for development, evaluation, approval, and distribution of HIV-related vaccines, drugs, and devices. This plan should draw upon research of Federal and State governments, the private sector, academia, and national laboratories.

6. Provide me, within 120 days, with an assessment of private incentives for development and marketing of HIV products, including an evaluation of the need, if any, to have Federal authority with which to offer increased incentives in exchange for royalties, licenses, or pricing concessions. This assessment should take into consideration solutions proposed in the February 1986 report of the Tort Policy Working Group. In doing this assessment, please consult with the Departments of Justice and Defense.

7. Undertake an evaluation of our current system of health care financing to be completed within 1 year.

8. Conduct specific studies of ways to better promote out-of-hospital and case managed care; to encourage States to establish insurance risk pools for medically uninsurable persons; and to increase the responsiveness of the public health and health services system to HIV-infected infants, children, adolescents, and to low-income disabled individuals.

9. Provide me an update by December 15, 1988, of the 1986 PHS plan for combatting HIV infection, reflecting, in part, both the Commission Report and the recent Public Health Service Charlottesville planning conference.

I am directing Donald Ian Macdonald, Deputy Assistant to the President for Drug Abuse Policy, to monitor progress on our response to the Commission's Report and provide me with status reports in September and December, 1988. Please provide Dr. Macdonald with appropriate information about your progress.

RONALD REAGAN

Memorandum for the Attorney General

I have approved a 10-point action plan as part of my response to the Report of the Presidential Commission on the Human Immunodeficiency Virus (HIV) Epidemic. This plan expresses my concern about fair and compassionate treatment of HIV-infected individuals.

To carry this out, please provide me with an expeditious review and response to the Commission's recommendations on how the Federal government should provide direction and leadership in encouraging nondiscrimination for HIV-infected individuals, including a review of current Federal and State laws in this area.

I am directing Donald Ian Macdonald, Deputy Assistant to the President for Drug Abuse Policy, to monitor progress on our response to the Commission's Report and provide me with status reports in September and December, 1988. Please provide Dr. Macdonald with appropriate information about your progress.

RONALD REAGAN

Memorandum for the Secretary of State

I have approved a 10-point action plan as part of my response to the Report of the Presidential Commission on the Human Immunodeficiency Virus (HIV) Epidemic. This plan includes developing a multi-focused international initiative involving: encouragement and assistance to international HIV efforts, with emphasis on less-developed countries; a heightened U.S. commitment to international technical assistance within established technology transfer laws; and the development of a 3-year plan for international efforts against HIV infection.

In carrying out your functions, I ask that you address HIV-related activities as follows:

1. Review your FY 1989 spending plans to incorporate relevant recommendations of my HIV Commission;

2. Include in your FY 1990 budget submissions appropriate funds for the United States regular and special contributions to international HIV efforts, especially those in less-developed countries;

3. Continue to emphasize our commitment to international technical assistance; and,
4. Propose, within 120 days, a 3-year plan for international efforts against HIV infection.

I am directing Donald Ian Macdonald, Deputy Assistant to the President for Drug Abuse Policy, to monitor progress on our response to the Commission's Report and provide me with status reports in September and December, 1988. Please provide Dr. Macdonald with appropriate information about your progress.

RONALD REAGAN

Memorandum for the Director of the Office of Management and Budget

I have approved a 10-point action plan as part of my response to the Report of the Presidential Commission on the Human Immunodeficiency Virus (HIV) Epidemic. As you know, I am committed to ensuring that the Federal government's HIV-related activities receive appropriate resources and support, and that no impediments to their efficient use exist, consistent with good management.

In carrying out your functions, I ask that you address HIV-related activities as follows:

1. Consult with the General Services Administration, the Office of Personnel Management, and the Department of Health and Human Services to ensure that HIV activities included in the FY 1989 and FY 1990 budgets reflect appropriate funding, personnel levels, and office and laboratory space. The budget, as well as other management initiatives, should also address the removal of both administrative and statutory impediments to efficient use of these resources including grant, contract, and hiring procedures. OMB should take a positive role in removing any unnecessary administrative and management impediments to the agencies' attack on HIV infection.

2. Ensure that my FY 1990 budget for HIV-related activities is submitted to the Congress in a timely manner, and that the Congress is encouraged to act on it quickly.

I am directing Donald Ian Macdonald, Deputy Assistant to the President for Drug Abuse Policy, to monitor progress on our response to the Commission's Report and provide me with status reports in September and December, 1988. Please provide Dr. Macdonald with appropriate information about your progress.

RONALD REAGAN

Memorandum for the Director of the Office of Personnel Management

I have approved a 10-point action plan as part of my response to the Report of the Presidential Commission on the Human Immunodeficiency Virus (HIV) Epidemic. The plan directs every Federal agency to adopt a policy based on your Office's "Guidelines for AIDS Information and Education and for Personnel Management."
To carry this out, you should offer Federal departments and agencies the assistance of your Office in helping develop any necessary agency modifications.

I am directing Donald Ian Macdonald, Deputy Assistant to the President for Drug Abuse Policy, to monitor progress on our response to the Commission's Report and provide me with status reports in September and December, 1988. Please provide Dr. Macdonald with appropriate information about your progress, including an update at regular intervals on agency actions on the guidelines.

RONALD REAGAN